Effects of Cognitive Remediation on Cognition in Young People at Clinical High Risk of Psychosis

Participants were randomised to either the BFP or a control treatment consisting of commercial computer games (CG). Participants were not blind to group allocation but all cognitive and symptom raters were. The 40 hours of BFP or computer game activity was expected to occur 4 days a week, for an hour each day, over a period of 10-12 weeks. The primary outcome was cognitive function assessed using the MATRICS consensus cognitive battery MCCB) (Nuechterlein and others 2008). The secondary outcome was social and role functioning assessed with Global Functioning: Social and Role scales. All clinical and cognitive assessments using symptom, functioning and cognitive measures were performed at baseline, post-treatment (at 3 months) and at 9-month follow-up (i.e. 9 months post baseline or 6 months after post-treatment assessment).

Inclusion criteria

1.

• Male or female between 12 and 35 years old.
• Understand and sign an informed consent (or assent for minors) document in English.
• Must meet the NAPLS substance use criteria (see guidelines).
• Meet diagnostic criteria for prodromal syndrome as per COPS Criteria (see below) or if under 19 meet criteria for schizotypal personality disorder.

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Exclusion criteria

• Meet criteria for current or lifetime Axis I psychotic disorder, including affective psychoses and psychosis NOS.
• No current treatment with antipsychotic medication unless it can be clearly demonstrated that the diagnostic prodromal criteria were present prior to the antipsychotic.
• Impaired intellectual functioning (i.e IQ<70); however those with an IQ in the 65-69 range will be included if the WRAT reading >75.
• Past or current history of a clinically significant central nervous system disorder that may contribute to prodromal symptoms or confound their assessment.
• Traumatic Brain Injury that is rated as 7 or above on the Traumatic Brain Injury screening instrument.
• The diagnostic prodromal symptoms are clearly caused by an Axis 1 disorder, including substance use disorders, in the judgment of the evaluating clinician. Other non-psychotic DSM-IV disorders will not be exclusionary (e.g. substance abuse disorder, major depression, anxiety disorders, Axis II Disorders), as long as the disorder does not account for the diagnosis of prodromal symptoms.

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